The utility of adrenal and ovarian venous sampling in a progesterone-producing adrenal tumor and review of the literature

Duan, Lian; Yang, Yingying; Gu, Yu; Zhang, Xiaobo; Mao, Quanzong; Pan, Boju; Deng, Chengyan; Pan, Hui; Zhu, Huijuan

doi:10.1007/s12020-019-02007-7

Cited by 10 publications

(12 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The present wide steroid profile sheds light on previous reports of tumors reportedly secreting a single steroid [ 29 ]. The complexity of steroidogenesis [ 30 ] indicates that steroidogenically active tumors are likely to secrete multiple steroids, including precursors and metabolites of canonical bioactive steroids.…”

Section: Discussionsupporting

confidence: 54%

Depot Pure GnRH Antagonist for Long-term Treatment of Ovarian Hyperthecosis Monitored by Multisteroid LCMS Profiling

Schmidli

Savkovic

et al. 2021

Journal of the Endocrine Society

View full text Add to dashboard Cite

Ovarian hyperthecosis (OHT), severe hyperandrogenism after menopause in the absence of ovarian or adrenal tumors, is usually treated by surgical excision. We report a 58-year-old woman presenting with severe hyperandrogenism (serum testosterone 15.7-31.0 nmol/L, normal female <1.8 nmol/L) with menopausal gonadotropins and virilization but no adrenal or ovarian lesions. Multi-steroid profiling by liquid chromatography-mass spectrometry (LCMS) of adrenal and ovarian vein samples identified strong gradients in left ovarian vein (10-30-fold vs peripheral blood in 17OHP4, 17 OHP5, A4, T, DHEA) but right ovarian vein could not be cannulated with the same findings in a second ovarian vein cannulation. OHT diagnosis was confirmed by an injection of a depot pure GnRH antagonist (80 mg Degarelix, Ferring) producing a rapid (< 24hr) and complete suppression of ovarian steroidogenesis as well as serum LH and FSH lasting at least 8 weeks with reduction in virilization but injection site reaction and flushing and vaginal spotting, ameliorated by an estradiol patch. Serum testosterone remained suppressed at 313 days after the first dose despite recovery of menopausal gonadotropins by day 278 days. This illustrates use of multi-steroid LCMS profiling for confirmation of the OHT diagnosis by ovarian and adrenal vein sampling and monitoring of treatment by peripheral blood sampling. Injection of a depot pure GnRH antagonist produced rapid and long-term complete suppression of ovarian steroidogenesis maintained over 10 months. Hence a depot pure GnRH antagonist can not only rapidly confirm the OHT diagnosis but also induce long-term remission of severe hyperandrogenism without surgery.

show abstract

Section: Discussionsupporting

confidence: 54%

Depot Pure GnRH Antagonist for Long-term Treatment of Ovarian Hyperthecosis Monitored by Multisteroid LCMS Profiling

Schmidli

Savkovic

et al. 2021

Journal of the Endocrine Society

View full text Add to dashboard Cite

show abstract

“…During bleeding, such patients are given progesterone treatment. There is withdrawal bleeding [16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Clinical Study of Progesterone Combined with Vitamin B6 in the Treatment of Amenorrhea Endocrine Disorders Caused by Antipsychotics

Zhao

Zhai

et al. 2022

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

Background. Endocrine disorders such as amenorrhea, lactation, and irregular menstruation caused by antipsychotics are common in female patients. How to reduce or eliminate these adverse reactions is a matter of concern. Objective. To evaluate the therapeutic effect of progesterone in combination with vitamin B6 in the treatment of antipsychotic-induced amenorrhea. Methods. In our hospital, from May 2019 to May 2021, 120 patients with amenorrhea caused by antipsychotics who underwent surgery were selected for this prospective study. The random residue grouping method divided them into a progesterone group (60 cases) and a vitamin B6 group (60 cases). Among them, the progesterone group was treated only with progesterone, while the vitamin B6 group was given progesterone in combination with vitamin B6. The differences in endocrine index, prolactin, uterine size, and endometrial thickness, effectiveness, and safety analysis of the progesterone and vitamin B6 groups of patients were observed and compared. Results. Before treatment, there was no change in the comparison of endocrine indexes between the progesterone and vitamin B6 groups ( P > 0.05 ). After 1 month of treatment, there were significant differences in estradiol, prolactin, and follicle-stimulating hormone between the progesterone and vitamin B6 groups of patients ( P < 0.05 ). After 1 month of treatment, there were significant differences in prolactin, uterine size, and endometrial thickness, and the vitamin B6 group was significantly lower than the progesterone group ( P < 0.05 ). The clinical efficiency of 95.00% in the vitamin B6 group was significantly higher than 83.33% in the progesterone group ( P < 0.05 ). There were no adverse reactions in the progesterone and vitamin B6 groups. Conclusion. The effectiveness of progesterone combined with vitamin B6 in treating amenorrhea caused by antipsychotics is significantly better than simple progesterone, which can effectively improve the endocrine condition of patients and provide a reference for the clinical treatment of amenorrhea caused by antipsychotics.

show abstract

“…5 Interventional radiologists may sample the adrenal vein to detect an aldosterone-producing adrenal adenoma in patients with hypertension. 6 Gonadal vein blood sampling is not done routinely, although we often cannulate the ovarian veins when treating pelvic congestion syndrome in order to embolize and sclerose the veins.…”

Section: Discussionmentioning

confidence: 99%

Virilization caused by ovarian nodular hyperthecosis in a postmenopausal woman

Tulandi

Boucher

et al. 2022

CMAJ

View full text Add to dashboard Cite

The utility of adrenal and ovarian venous sampling in a progesterone-producing adrenal tumor and review of the literature

Cited by 10 publications

References 13 publications

Depot Pure GnRH Antagonist for Long-term Treatment of Ovarian Hyperthecosis Monitored by Multisteroid LCMS Profiling

Depot Pure GnRH Antagonist for Long-term Treatment of Ovarian Hyperthecosis Monitored by Multisteroid LCMS Profiling

Clinical Study of Progesterone Combined with Vitamin B6 in the Treatment of Amenorrhea Endocrine Disorders Caused by Antipsychotics

Virilization caused by ovarian nodular hyperthecosis in a postmenopausal woman

Contact Info

Product

Resources

About